TEVA Pharmaceutical Industries Ltd MS-GA-301 Subject Resupply

Site Information
Caller Name: Investigator Name Site Number: Date/Time of Call: Maria Tanasie Mihaela Simu 5224 28/MAY/2012 09:37 AM EET

Subject Information
Subject Number: Date of Birth Pack Number(s): Visit Type: Visit: 522406 05/Jul/1967 811871, 811872, 811873 Scheduled Scheduled Visit 2E Month 18 Open Label Phase

Please schedule this subjects next visit between 23/Aug/2012 and 31/Aug/2012 . N/A This subject has been successfully resupplied. Please place this confirmation in the appropriate file. Re-supply Visit Schedule (all dates are target date +/- 4 days) Scheduled Visit 1 Month 1 Placebo Controlled Phase between: Scheduled Visit 2 Month 3 Placebo Controlled Phase between: Scheduled Visit 3 Month 6 Placebo Controlled Phase between: Scheduled Visit 4 Month 9 Placebo Controlled Phase between: Scheduled Visit baseline Open Label phase Month 12 between: Scheduled Visit 1E Month 15 Open Label Phase between: Schedule Visit 2E Month 18 Open Label Phase between: Schedule Visit 3E Month 21 Open Label Phase between: Schedule Visit 4E Month 24 Open Label Phase between: 03/Jan/2011 02/Mar/2011 06/Jun/2011 05/Sep/2011 29/Nov/2011 29/Feb/2012 28/May/2012 23/Aug/2012 and 31/Aug/2012 21/Nov/2012 and 29/Nov/2012

Fax: +1 703-814-8501 ICON Clinical Research Web: http://icophone.iconplc.com ICOPhone Help Desk: Dial ATT 0808-03-4288 then 888-426-8801
This document contains confidential information and is intended only for the use of the individual or entity named on the document. If you have received this in error, please notify ICON Clinical Research by telephone at the ICOPhone Help Desk (above) so we may arrange for the return and delivery of this document to the intended party.

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DocID: 8277598

TEVA Pharmaceutical Industries Ltd MS-GA-301 Subject Resupply

Schedule Visit 5E Month 30 Open Label Phase between: Schedule Visit 6E Month 36 Open Label Phase between: 20/May/2013 and 28/May/2013 16/Nov/2013 and 24/Nov/2013

Fax: +1 703-814-8501 ICON Clinical Research Web: http://icophone.iconplc.com ICOPhone Help Desk: Dial ATT 0808-03-4288 then 888-426-8801
This document contains confidential information and is intended only for the use of the individual or entity named on the document. If you have received this in error, please notify ICON Clinical Research by telephone at the ICOPhone Help Desk (above) so we may arrange for the return and delivery of this document to the intended party.

2 of 2

DocID: 8277598